DST (Suture Technique) Asian Double Eyelid Surgery - Natural?

Question

Is the DST (suture technique) asian double eyelid surgery look natural when the eyes are closed? I have heard that there will be a line / fold visible when the eyes are closed, which is not natural looking. Does the incisional method provide more natural looking eyes when the eyes are closed?

Thomas Buonassisi, MD · Answer

The suture technique results in very natural looking double eyelid creases. Even with the eyelids closed . The extremely fine sutures provide a gentle compression of the eyelid structures to form a crease from within that is not generally visible unless the eyes are open. Although the suture technique has limitations, for the right candidate it produces extremely natural result with a short recovery time.

Charles S. Lee, MD, FACS · Answer

The Double sutures with twisting is an excellent technique for the correct candidate. It requires both eyes to have good function of the eyelid - opening muscle (levator muscle). It does not allow for making the two eyes more symmetric if you have minor differences, and it should not be used if you have any ptosis.

	This is a subset of sutures based surgeries which is supposed to have more longevity than other types of suture based surgeries. It was described by Drs. Minami and Kure, plastic surgeons in Japan.

Kenneth D. Steinsapir, MD · Answer

DST can be very natural. The real issue is longevity, lash ptosis, and lack of customization of how the upper eyelid fold lays on the eyelid platform. For these reasons, I don't perform DST. DST is really a method for non-surgeons. If you have true eyelid expertise, the open method provides a superior method for definitively dealing the eyelid. However, it requires training, skill, experience, and yes more costly resources than threading a suture. For this reason DST is very popular in Asian countries.

Leo Kim, FRACS(Plast), MS(Plast), MBBS(Hons) · Answer

That depends on each individual techniques employed but in general suture techniques tend to be non-dynamic so some may consider it more "unnatural". However this is not always the case as well done DST looks very natural even in dynamic motion of the eyelids.
Wish you the best in your journey,
Dr Leo Kim, Specialist Plastic Surgeon in Sydney

Eric In Choe, MD · Answer

There are many different techniques for Asian eyelid surgery and they all have pros and cons. Most reputable surgeons don't just use one technique on every patient. Instead, they first understand what needs be done on their patients and choose the best technique to achieve the goal. 

	Seeing a visible "fold/line" can potentially occur with any technique.

	It's the surgeon,not the technique, that is most important in achieving a good outcome in Asian eyelid surgery.

DST (Suture Technique) Asian Double Eyelid Surgery - Natural?

Answers (7)